中医辨证治疗IgA肾病疗效观察

Dialectical Therapeutic IgA Nephropathy Curative Effect Observes Chinese Medicine

目的：观察中医辨证治疗IgA肾病的临床疗效。方法：将90例IgA肾病患者随机分为两组。对照组30例,采用西医常规抗凝、抗感染、降压治疗;24h尿蛋白≥1g/24h者予雷公藤多甙1mg/（kg.d）;肾病综合征或大量蛋白尿者,予强的松1mg/（kg.d）（最大剂量〈60mg/d）;病情反复者加环磷酰胺100mg/d,累积6~8g停药。治疗组60例,在对照组治疗基础上,加用中医辨证治疗,疗程3个月。结果：治疗组完全缓解15例,显效21例,好转16例,无效8例,总有效率为86.67%;对照组完全缓解4例,显效7例,好转8例,无效11例,总有效率为63.33%。两组总有效率比较,差异有统计学意义（P〈0.05）。治疗组治疗后尿红细胞计数、24h尿蛋白定量与治疗前比较,差异有统计学意义（P〈0.01）;与对照组比较,差异有统计学意义（P〈0.01）。而治疗前后血肌酐、尿素氮、尿酸比较,差异无统计学意义（P〉0.05）。结论：中医辨证论治加西医治疗效果优于单纯西医治疗。

Objective：To observe the TCM treatment of IgA nephropathy clinical efficacy.Methods：90 patients with IgA nephropathy randomly divided into two groups.Control group of 30 cases,anticoagulant,resistance to infection,Western medicine antihypertensive therapy;≥ 1g/24h 24h urine protein to Tripterygium wilfordii more glucoside 1mg/（kg·d）;Nephrotic syndrome or a large number of proteinuria,to prednisone 1mg/（kg·d）（maximum dosage60mg/d）;The illness relapses of 100mg/d,plus cyclophosphamide cumulative 6-8g withdrawal.Treatment group 60 cases,In the control group therapy basis,Add with TCM syndrome differentiation and treatment,treatment march.The clinical efficacy was observed,24-hour urinary protein quantitative,urine RBC count,creatinine,urea nitrogen,serum uric acid changes.Results：15 cases in treatment group complete remission,powerfully 21 cases,improving 16 cases,invalid 8 cases,The total effective rate was 86.67%;The control group complete remission 4 cases,powerfully 7 cases,improvement in 8 cases,invalid in 11 cases,The total effective rate was 63.33%.Two group total effectiveness comparison,the difference was statistically significant（P〈0.05）.The treatment group after the treatment of urine RBC count,24 h urinary protein of quantitative and before treatment,there is a significant difference compared statistical significance（P〈0.01）;Compared with controls,the difference was statistically significant meaning（P〈0.01）.And after treatment serum creatinine,blood urea nitrogen,uric acid comparison,difference was statistically significant（P〈0.05）.Conclusion：the syndrome differentiation and treatment with western medicine therapy effect is better than pure western medicine therapy.